I. - Information about applicant
| 1. - Personal Data: | |||||
| 1.1 Family Name: | 1.2 First Name: | ||||
| 1.3 Middle Name: | 1.4 (//) Date of Birth (month/day/year) | 24.01.1971.. | |||
| 1.5 Place of Birth: | .- | 1.6 Sex: | ./Male __ ./Female _ X _ | ||
| 1.7 - Country of Citizenship: | |||||
| 1.8 ( , ) Name As Written on Official Documents | Tulepkaliyeva Dina Muratovna | ||||
| 2. - Contact Information | |
| 2.1 City and region of permanent residence/ | |
| 2.2 ( ) Phone (include area code) | 8-(727)-373-73-18 |
| 2.3 /Mobile Phone | +7-701-353-7001 |
| 2.4 /E-Mail Address | [email protected] |
| 3. - Current work place | |||
| 3.1 -Company name | Ұ | ||
| 3.2 -Position / since/ | 2010 | ||
| 3.3 ( ) -Working Period (years and months)/ | |||
| 3.4 ? Are you an owner or co-owner of the company? | ___ /YES __ X_ _ / NO | ||
II. -Information about Company
| 4. -General information about Company / | ||||
| 4.1 ( - : , ..) -Name of organization: | - Ұ | |||
| 4.2 /Founded: | 2002 . | |||
| 4.3 /Phone: | 8-(727)-373-73-18 | |||
| 4.4 /Fax: | 8-(727)-373-73-18 | |||
| 4.5 ()/E-mail: | [email protected] | |||
| 4.6 /Web Site: | aimura.kz | |||
| 4.7 /Correspondence address: | 050063, . -2, 4 .73, , | |||
| 4.8 .. / Name of Director: | ||||
| 4.9 /Contact information of Director: | +7-701-353-7001 8-(727)-373-73-18 | |||
| 4.10 /Direction of activity: | __ / Manufacture _ X _ /Service __ ()/Other/ _ ( ), ( ) | |||
| 4.11 ( ) , ( , , )/Specify the business sector of the company, and specify in more detail sub-sector (if the company diversified, specify no more than two sectors which are connected with the trip to the U.S.): | - -55 () LEGAL OASIS MASTERgrad ( ) ( ) ( ̻ LEGAL OASIS MASTERgrad): - - | |||
| 4.12 / ?/What specific products are you currently producing for sale? | , LEGAL OASIS MASTERgrad | |||
| 4.13 /? ./ What is your market for those products? Or Describe your major buyers. | Ż ( ) , - (- - , , , , - ) .. | |||
| 4.14 ( )/Yearly sales (in $US): | START-UP -2012 ( ) | |||
III.
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III. Purposes of participation in the Business Connections Program /
| 5.1 , / , / Specify economic fields/products/services of US companies, that interesting for applicant company: |
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| 6. /Statement of Purposes | |
| 6.1 , , , ?/What specific equipment, technology or materials are you looking for to expand your current operations? | |
| , LEGAL OASIS MASTERgrad |
| 6.2. ( )?/What kind of deals with the American companies would you like to have (can choose few variants)? | _+_ / transfer of technology | :/ Explain your answers , .. ( ). ( ) (). , ( ). |
| _+_ / purchase/sell equipment | ||
| _+_ / recruitment of experts and specialists | ||
| _+_ , /joint product/services delivery | ||
| _+_ / purchase licenses | ||
| __ / purchase franchises | ||
| __ / opening of joint ventures | ||
| __ ()/other _____________________ |
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| 6.2 ? How your participation in the program will affect the company? | |
| Ȼ ( ), .. , ( ), ( , -: , . , ). | |
| 6.3 ? What do you plan to achieve as a result of your tour in US? | |
| (, ), .. . , .. Ȼ ( ) ( ). , . | |
| 6.4 ? What does the applicant and the applicants company plans to do as a result of the visit to the USA? / | |
| ( (, ), . LEGAL OASIS MASTERgrad ( ). , , ( Ż), ( Ȼ - ..). | |
| 6.5 , . Name the main tasks at your company that should be solved with the help of this program/ | , , ( ). |
| 7. Information about potential business connections and forms of partnership | |
| 7.1 ? Have you potential American companies for business deals? | __ /YES _ X _ /NO |
| , : ( ; ; ) If YES, fill the data (Form of partnership/ Company Name/ Contact information/) | |
| 7.2 ? ( , ) Do you have business connections in US? (specify Company name, state; Form and years of partnership / |
| 7.3 ? ( , ) Do you have partners abroad? (specify Company name, state; Form and years of partnership) / |
| 8. / Role and authority of applicant | |||
| 8.1 ? What role of applicant in partnership between applicants Company and US companies? / | , LEGAL OASIS MASTERgrad ( ). | ||
| 8.2 ? What kind of authority do you represent? / | / looking for partners | _ X _ /YES __ /NO | |
| / for negotiations | _ X _ /YES __ /NO | ||
| /for sign contracts/ | _ X _ /YES __ /NO | ||
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, / I certify that the information given in this application is complete and accurate
/Data
Signature of applicant _ ______ 22 _ _ 2012
/Data
Signature and stamp of Head of Company 22 _ _ 2012
